Nutritional status and clinical outcome in elderly female surgical orthopaedic patients

The possible relationship between nutritional status and clinical outcome following orthopaedic hip surgery was investigated. The nutritional status of 60 elderly female patients admitted for elective total hip replacement (THR) and emergency fractured neck of femur surgery (FNF) was measured over time. Specific measures of clinical outcome, including well-being and functional status, were monitored during hospital stay and at 4, 8 and 26 weeks following discharge. Patients were allocated to a high nutritional risk group where any three of the following were less than the 5th percentile value: serum albumin, haemoglobin, triceps skinfold thickness, mid-upper arm muscle circumference and body weight. Using this definition, malnutrition was present in 4% of THR patients and 41% of FNF patients. It was found that the high risk patients had significantly longer convalescence periods, (median stay27.5 days compared with 0 days, P < 0.0009), and a greater proportion were dependent upon walking frames at 6 months (46% compared with 11%, P < 0.01). Fifty percent of the high risk patients had been living independently prior to admission, in contrast only 29% had returned to their homes at 6 months after discharge. The results indicate an apparent link between clinical outcome and nutritional status based upon the allocation procedure employed, which has the potential for ensuring cost-effective nutritional intervention.

The Nutritional Status of Children and Adolescents with HIV/AIDS on Antiretroviral Therapy

The objective of this cross-sectional study was to assess the nutritional status of children and adolescents with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) receiving highly active antiretroviral therapy (HAART). One hundred and eighteen subjects aged 6-19 years attending an outpatient clinic in Sao Paulo city were involved in the study. The following anthropometric measurements were assessed: weight, height, waist circumference and triceps and subscapular skinfold thickness. One (0.9%) adolescent was diagnosed with abdominal obesity based on waist circumference measurement; three (2.5%) adolescents were obese based on subscapular skinfold thickness. According to the body mass index, the population studied was mainly eutrophic. The prevalence of fat redistribution, a characteristic of patients with HIV/AIDS under HAART, was low. We advise the development of further studies to assess the nutritional status of children and adolescents with HIV/AIDS using anthropometric measurements as well as computed tomography to detect fat redistribution.

Dietary practices and nutritional status of 0-24-month-old children from Brazilian Amazonia

Objective: To assess the nutritional status and dietary practices of 0-24-month-old children living in Brazilian Amazonia. Design: Cross-sectional study. Information oil children`s dietary intakes was obtained from diet history data. Weight and length Were measured for anthropometric evaluation. Fe status Was assessed Using fasting venous blood samples; Hb, serum ferritin and soluble tranferrin receptor concentrations were measured. Setting: The towns of Assis Brasil and Acrelandia in the state of Acre, north-west Brazil. Subjects: A total of sixty-nine randomly selected 0-24-month-old children. Results: Of these children, 40.3 % were anaemic, 63.1% were Fe-deficient, 28.1% had Fe-deficiency anaemia and 11.6% were stunted. Breast-feeding was initiated by 97.1% of mother followed by early feeding with complementary foods. The dietary pattern reflected a high intake of carbohydrate-rich foods and cow`s milk, with irregular intakes Of fruit, Vegetables and meat. All infants and 92.3% of toddlers were at risk Of inadequate Fe intakes. Fe from animal foods contributed Oil average 0.5% and 14.3% to total dietary Fe intake among infants and toddlers, respectively. Conclusions: Poor nutritional status and inadequate feeding practices in this study population reinforce the importance of exclusive breast-feeding during the first 6 months of life. Greater emphasis is required to improve the bioavailability of dietary Fe during complementary feeding practices.

Soil-liming effects on the development and nutritional status of the carambola tree and its fruit-yielding capacity

Soil acidity is one of the most important factors limiting agricultural production in the tropics. For this reason, the objective of this research work was to evaluate the effects of soil liming on the performance of carambola (Averrhoa carambola) trees. The experiment took place at the Citrus Experimental Station in Bebedouro, state of São Paulo, Brazil. The soil was a Typic Haplustox (V = 26% at the 0- to 20-cm layer) between August 1999 and July 2003. The following doses of limestone were employed: 0, 1.85, 3.71, 5.56, and 7.41 t ha(-1). During 40 months after the experiment was set up, soil chemical attributes were periodically examined. For a period of 2 years, the trees had their leaves analyzed for micro-and macronutrients; their trunk diameter, height, and crown volume measured; and the production of fruits determined. Liming improved in evaluated chemical attributes of the soil: pH, calcium (Ca), magnesium (Mg), BS, V, and hydrogen and aluminium (H + At) from the upper 60 cm of soil when the samples were taken from both the line and between the lines of plants. In the leaves, the levels of Ca and Mg also increased. The highest fruit yields were observed when soil base saturations reached 45% on the lines and 50% between the lines, as well as when foliar levels of 8.0 g of Ca and 4.7 a of Mg per kilogram of leaves were attained.

Effects of low fat and babassu fat diets on nutritional status in obstructive cholestasis in young rats

OBJETIVO: Testar os efeitos de uma dieta com baixo teor de gordura comparada a uma dieta com gordura de babaçu sobre o estado nutricional em ratos jovens com colestase obstrutiva. MÉTODOS: Submetemos 40 ratos divididos em quatro grupos de 10 animais a partir do P21 (21º dia pós-natal) até o P49 a dois dos seguintes tratamentos: ligadura e ressecção do ducto biliar comum ou operação simulada e dieta com baixo teor de gordura (óleo de milho fornecendo 4,5% da quantidade total de calorias) ou dieta com gordura de babaçu (essa gordura fornecendo 32,7% e óleo de milho fornecendo 1,7% da quantidade total de calorias). Foi mensurado o ganho de peso a cada 4 dias do P25 ao P49. A função de crescimento de Verhulst foi ajustada aos valores de ganho de peso. A velocidade e a aceleração de crescimento nos mesmos momentos foram estimadas usando a mesma equação. Foram mensurados: quantidade de ração ingerida e ingestão energética total do P21 ao P49, utilização de energia do P25 ao P49, gordura absorvida e balanço de nitrogênio (BN) do P42 ao P49. A ANOVA com dois fatores e o método de S.N.K para comparações pareadas foram utilizados para estudar os efeitos, sobre as variáveis, da colestase e das dietas e sua interação (p<0,05). RESULTADOS: em ratos com colestase e dieta com baixo teor de gordura, houve maior velocidade de crescimento no P45, maior aceleração de crescimento no P41 e P45, maior utilização de energia, maior percentual de gordura absorvida e maior BN do que em ratos com colestase e dieta com gordura de babaçu. CONCLUSÃO: A dieta com baixo teor de gordura atenua a restrição de crescimento provocada pela colestase e proporciona melhor aproveitamento da dieta e maior incorporação da proteína ingerida do que a dieta com gordura de babaçu.

Evaluation of nutritional status in patients with endemic pemphigus foliaceus

A avaliação nutricional foi realizada em dezesseis doentes portadores de pênfigo foliáceo endêmico, sendo dez portadores da forma localizada da doença (Grupo G1) e seis portadores da forma disseminada da mesma (Grupo G2). Foram realizadas avaliações antropométricas (peso, altura, índice de Quetelét, prega cutânea tricipital, prega cutânea subescapular, circunferência braquial, circunferência muscular do braço, área do braço, área muscular do braço, área adiposa do braço) e laboratorial (eletroforese de proteínas séricas). Quanto aos parâmetros antropométricos, observaram-se as seguintes alterações: a circunferência do braço, área do braço, e área muscular do braço mostraram valores mais baixos nos doentes do grupo G2 que nos do grupo G1. O peso e a circunferência muscular do braço, por sua vez, mostraram tendência a valores mais baixos nos doentes do grupo G2 que nos do grupo G1. A eletroforese de proteínas revelou valores de albumina diminuídos em ambos os grupos, e menores nos doentes do grupo G2. Quanto às demais frações, com exceção das beta globulinas, não foram evidenciadas alterações. A análise global dos resultados permite concluir que os doentes com pênfigo foliáceo endêmico apresentam um quadro de desnutrição proteica, mas não calórica. Esta desnutrição mostrou-se mais acentuada no pênfigo foliáceo disseminado.

Grade of esophageal cancer and nutritional status impact on postsurgery outcomes

CONTEXTO: A desnutrição protéico-energética constitui causa previsível para o desenvolvimento de complicações pós-operatórias e pior prognóstico de pacientes cirúrgicos. OBJETIVO: Estudar a associação de indicadores de estado nutricional com estádio da doença e as principais complicações e mortalidade pós-operatória de pacientes com câncer de esôfago. MÉTODO: Foram avaliados retrospectivamente 100 prontuários de pacientes com câncer de esôfago (38-81 anos) de ambos os sexos (85% masculino e 15% feminino) submetidos a esofagectomia (n = 25) e gastrojejunostomia (n = 75), no período de 1995 a 2004. Os dados coletados foram: história clínica, exame endoscópico, estádio (TNM-UICC), estado nutricional (índice de massa corporal, percentual de perda de peso - %PP, albuminemia e contagem de linfócitos total) e evolução clínica pós-operatória. Houve composição dos grupos de acordo com o porte da cirurgia (grande x pequeno). Foi realizada a associação entre as complicações pós-operatórias e a mortalidade (após pós-operatório de 30 dias). As comparações entre médias dos dois grupos foram feitas pelo teste t de Student e a existência de associações entre variáveis testadas pelos testes de χ2 ou exato de Fisher com P = 0,05. RESULTADOS: Houve predomínio dos tumores avançados (estádio III e IV), com a presença de disfagia em 95% dos pacientes e perda ponderal >10%, anterior ao diagnóstico, em 78%. A obstrução esofágica, presente em 77 pacientes, foi associada (P = 0,0021) com o baixo índice de massa corporal (desnutrição protéico-energética). A %PP e a hipoalbuminemia associaram-se estatisticamente (P<0,05) com o estádio avançado da doença. As complicações pós-operatórias precoces ocorreram em 69,2% e 30,7% dos pacientes submetidos a esofagectomia e ostomias, respectivamente, com predomínio das infecciosas nas ostomias (80%) e as pleuropulmonares nas esofagectomias (61%). A albuminemia foi menor nos pacientes submetidos as ostomias, tendo sido a hipoalbuminemia associada (P<0,05) com a ocorrência de complicações pós-operatórias e mortalidade. A %PP e a contagem de linfócitos total associaram-se com as complicações pós-operatórias precoces e infeccionas nas ostomias e a contagem de linfócitos total, com a mortalidade operatória nas esofagectomias. CONCLUSÕES: O estado de DPE esteve associado às complicações pós-operatórias apenas nos pacientes submetidos a ostomias, sem presença destas associações nas esofagectomias.

Dental caries and the nutritional status of preschool children: a spatial analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The malarial impact on the nutritional status of Amazonian adult subjects

A avaliação antropométrica (pêso, altura, circunferência branquial, prega cutânea tricipital, prega cutânea subescapular, índice de Quetelet e circunferência muscular do braço) e bioquímica (proteínas e lipides) foi realizado em 120 indivíduos (93 masculinos e 27 do sexo feminino), de 17 a 72 anos de idade, moradores de área endêmica de malária (Humaitá -AM). de acordo com a história da doença (malária) eles foram divididos em 4 grupos: G1 - controle (n = 30), sem história de malária; G2 - controle (n = 40), com história de malária, mas sem manifestação de doença atual; G3 - doentes com Plasmodium vivax (n = 19) e G4 - doentes com Plasmodium faleiparum (n = 31). O diagnóstico de malária foi estabelecido por manifestações clínicas e confirmado laboratorialmente (gota espessa e esfregaço). No global as medidas antropométricas e bioquímicas discriminaram os grupos diferentemente. As medidas antropométricas do pêso, altura, reservas calóricas e estoque proteicos somáticos, apresentaram pouca sensibilidade, discriminado apenas os grupos extremos (Gl > G4). As medidas bioquímicas, no geral diferenciaram dois grandes grupos, os sadios e os doentes (G1+G2) e (G3+G4). Os doentes com Plasmodium falciparum (G4) foram os que se apresentaram em pior estado nutricional para a maioria das variáveis, sem entretanto, nenhuma variável individual que os discriminasse significativamente do G3. Estes dados permitem concluir que a malária resulta em desnutrição do hospedeiro, cuja gravidade está relacionada ao tipo e estágio da doença.

Nutritional status and functional capacity of hospitalized elderly

Background: The nutritional status of the aging individual results from a complex interaction between personal and environmental factors. A disease influences and is influenced by the nutritional status and the functional capacity of the individual. We asses the relationship between nutritional status and indicators of functional capacity among recently hospitalized elderly in a general hospital.Methods: A cross-sectional study was done with 240 elderly (women, n = 127 and men, n = 113) hospitalized in a hospital that provides care for the public and private healthcare systems. The nutritional status was classified by the MNA (Mini Nutritional Assessment) into: malnourished, risk of malnutrition and without malnutrition (adequate). The functional autonomy indicators were obtained by the self-reported Instrumental Activity of Daily Living (IADL) and Activity of Daily Living (ADL) questionnaire. The chi-square test was used to compare the proportions and the level of significance was 5%.Results: Among the assessed elderly, 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. All the IADL and ADL variables assessed were significantly more deteriorated among the malnourished individuals. Among the ADL variables, eating partial (42.9%) or complete (12.9%) dependence was found in more than half of the malnourished elderly, in 13.4% of those at risk of malnutrition and in 2.5% of those without malnutrition.Conclusion: There is an interrelationship between the nutritional status of the elderly and reduced functional capacity.

Food intake and nutritional status of hospitalised older people

Background and aims. Disease is influenced by the nutritional status of the individual. We have assessed the relationship between nutritional status and food intake among recently hospitalised older people. Methods. A cross-sectional study was undertaken with 240 older people in a hospital that provides care for the public and private healthcare systems. Nutritional status was classified by the MNA (Mini Nutritional Assessment) into: malnourished, risk of malnutrition and without malnutrition. Food intake was estimated by the reported food intake during a typical day. The Kruskal-Wallis test was used to compare the medians and the correlation coefficient of Spearman to verify the relationship between the consumption of energy, protein and vitamin C and MNA scores. Results. 33.8% were classified as adequate regarding nutritional status; 37.1% were classified as being at risk of malnutrition and 29.1% were classified as malnourished. The malnourished individuals reported significantly less energy and nutrient intake than those at risk of malnutrition or those without malnutrition (P=0.001). Not all nutrient intake, just some (iron, cholesterol and fibre), were lower in malnourished people. Conclusions and implications for practice. Deterioration of the nutritional status of older people is accompanied by a reduction in energy and some nutrient intake. The investigation of food intake in older people could provide important information about nutritional risk. © 2010 Blackwell Publishing Ltd.

Nutritional status, biological maturation and cardiorespiratory fitness in Azorean youth aged 11-15 years

Background: Sex and individual differences in biological maturity status can influence height, weight, and body fat. Thus, the rigorous control of these variables seems necessary for estimating overweight and obesity in adolescents. The aims of this study were to estimate the prevalence of overweight and obesity and over-fatness in Azorean adolescents and to examine the contributions of chronological age, sex, estimated maturity status, and cardiorespiratory fitness (CRF) to the risk of overweight and obesity and over-fatness. Methods. The sample comprised 1,206 youth aged 11-15 years (626 boys and 580 girls) from the Azores Islands, Portugal. Body mass, stature, and skinfolds (triceps and subscapular) were measured. Body mass index (BMI) was calculated and percent fat was predicted from skinfolds. Age- and sex-specific IOTF cut-off values of the BMI defined nutritional status. Biological maturation was estimated as present height expressed as a percentage of predicted adult (mature) stature. The CRF was analyzed from the 20-m shuttle run test. Results: The total prevalence rates of overweight/obesity and over-fatness were of 31% and 27%, respectively. Low CRF (unfit) and being average and advanced in maturity status were positively and significantly associated with overweight/obesity and with risk of being over-fatness in both sexes. Conclusions: High prevalence rates of overweight/obesity and over-fatness were identified in Azorean youth, and low CRF and advanced biological maturation were positively associated with overweight/obesity and over-fatness in our sample of adolescents. © 2013 Coelho-e-Silva et al.; licensee BioMed Central Ltd.